Provider Demographics
NPI:1013953033
Name:SCHMITT, KARL M (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:M
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636324
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6324
Mailing Address - Country:US
Mailing Address - Phone:859-301-3800
Mailing Address - Fax:859-301-3987
Practice Address - Street 1:413 S LOOP RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5446
Practice Address - Country:US
Practice Address - Phone:859-301-3800
Practice Address - Fax:859-301-3987
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64281777Medicaid
KY080092518OtherRAILROAD MEDICARE
KY220017409OtherRAILROAD MEDICARE
OH0101142Medicaid
KY0387604Medicare PIN
KY080092518OtherRAILROAD MEDICARE
KY220017409OtherRAILROAD MEDICARE